Mobilização e coleta das celulas progenitoras hemopoieticas perifericas para transplante autologo em pacientes onco-hematologicos

AUTOR(ES)
DATA DE PUBLICAÇÃO

2000

RESUMO

This is a prospective and controlled study to analyse the mobilisation and collection of pluripotent precUrsor cells in order to assess the predictive factors related to CD34+ yield in patients affected by haematological malignancies. From January/98 to AugusU99, 41 patients (26 Male/15 Female), with a median age of 35 years (12 59), underwent 115 prooodures for CD34+ cells collection. The diagnoses were: 21 (51.2%) non-Hodgkin Iymphomas (NHL); 15 (36.6%) Hodgkin s disease (HD); 2 (4.9%) chronic myeloid leukaemia (CML) and 3 (7.3%) multiple myeloma (MM). Patients were mobilised using chemotherapy (Cyclophosphamide (CY) 4 g/m2, CY 7 g/m2, Etoposide 2g/m2, "DHAP" or "Mini-lce" regimens) followed by G ar GM-CSF. Leukapheresis was started when peripheral white blood 0011 count (WBC) reached 1.0x109/L. The aim was to collect at least 5x1 06 CD34+ oollslKg of body weight. Eleven (9.5%) prooodures were performed in Dideco Vivacell BT 798 CEIA; thirty nine (33.9%) in Baxter CS 3000 plus and sixty-five (56.5%) in Fresenius AS 104 equipment. We analysed the following variables: age, diagnosis, CT mobilisation regimen, growth factor, previous CT lines, prior RT, WBC recovery and number of apheresis. For statistical analysis, we used descriptive statistics, Gaussian adjustment (goodness of fit), univariate analysis and, multivariate analysis (AN,OVA) Pearson s correlation and regression with bivariated Gaussian curves. We performed a median of three procedures per patient (1-6). The median of days needed for the WBC to reach 1.0 x 1~/L after "nadir" was 12 (7-19). The median of CD34+cells collected was 6.19 x 106/Kg (0.22-33.78). The median of CD34+ efficiency was 60.1 % (2.40-326.79). Eleven patients (26.8%) failed to collect the target of CD34+cells. Patients mobilised with CY 4 g/m2 presented recovery for WBC in less days (p=0.03) and less apheresis prooodures collected more CD34+ oolls (p=O.04). aphereses" and "type of mobilisation CT" (coefficients: 0.86 and 0.95 respectively). For "number of apheresis procedures" and WBC recovery", we obtained a correlation coefficient of 0.36 (p=0.02). This study shows the viability to mobilise and collect PBPC in patients with previous treatment for haematological malignancies, with high efficiency collection and low morbidity related to the procedures. There is a linear correlation between the days needed for WBC recovery afier mobilisation and the number of apheresis procedures to collect the target CD34+ cells. The study suggests that early WBC recovery, using mainly CY 4 glm2 mobilisation chemotherapy, is an important predictor for a low number of apheresis to achieve a good CD34+ yield

ASSUNTO(S)

sangue - transfusão leucocitos quimioterapia hematologia

ACESSO AO ARTIGO

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